Technical Field
[0001] The present invention relates to a grasping treatment unit which treats a grasped
treated target by using heat. In addition, the invention relates to a grasping treatment
instrument and a grasping treatment system, which each include the grasping treatment
unit.
Background Art
[0002] Patent Literature 1 discloses a grasping treatment instrument which grasps a treated
target between two jaws. In this grasping treatment instrument, the treated target,
which is grasped between one jaw and the other jaw, is treated by using the heat that
is produced by a heating portion which is provided in the one jaw. In addition, a
projection portion in which a grasping surface projects toward the other jaw is formed
on the jaw in which the heating portion is provided. That part of the treated target
grasped between the two jaws, which comes in contact with the projection portion,
is cut by a treatment using the heat, and that part of the treated target, which comes
in contact with the location on the grasping surface other than the projection portion,
is sealed.
Citation List
Patent Literature
Summary of Invention
Technical Problem
[0004] In the grasping treatment instrument of the above patent document 1, in the jaw in
which the heating portion is provided, the projection portion is provided from the
proximal portion to the distal portion. In the treatment using heat, there is a case
in which a blood vessel, the diameter (thickness dimension) of which is greater than
the dimension (total length) of the grasping surface in the longitudinal direction
of the jaw, needs to be but off. In this treatment, it is necessary to perform cutting
in a state in which the grasping surface is put in contact with the blood vessel over
the entire length in the longitudinal direction, and to seal, at the same time, that
part of the blood vessel, which lies between the cut part of the blood vessel and
the uncut remaining part of the blood vessel. However, the grasping treatment instrument
of the above patent document 1 is not configured such that, after the first cutting,
a seal part (seal margin) is formed between the end portion of the cut part and the
uncut part. Thus, with the grasping treatment instrument of the above patent document
1, it is difficult to perform treatment of cutting, while sealing, a blood vessel
or the like with a large diameter by multiple-time operations.
[0005] The present invention has been made in consideration of the above-described problem,
and the object of the invention is to provide a grasping treatment unit, a grasping
treatment instrument and a grasping treatment system, which secure a treatment performance
and treatment efficiency in a treatment of cutting, for example, a blood vessel with
a large diameter, by using heat.
Solution to Problem
[0006] To solve above mentioned problems, according to one aspect of the invention, a grasping
treatment unit includes that: a first jaw extending from a proximal portion toward
a distal portion thereof; a second jaw extending from a proximal portion toward a
distal portion thereof, and being openable and closable relative to the first jaw;
a heat applying portion including, on an outer surface of the first jaw, a grasping
surface opposed to the second jaw, the heat applying portion being provided in a grasping-surface-side
part in the first jaw; a projection portion provided in the heat applying portion
in a state in which the projection portion is continuous from the proximal portion
to the distal portion of the first jaw, the projection portion being configured such
that the grasping surface, compared to the other part of the heat applying portion,
projects toward the second jaw; a first thermal conduction portion provided in the
projection portion; and a second thermal conduction portion being continuous with
a distal portion side of the first thermal conduction portion in the projection portion,
and configured such that heat is directly conductible between the second thermal conduction
portion and the first thermal conduction portion, the second thermal conduction portion
having a thermal conductivity which is different from a thermal conductivity of the
first thermal conduction portion.
Advantageous Effects of Invention
[0007] According to the present invention, a grasping treatment unit, a grasping treatment
instrument and a grasping treatment system, which secure a treatment performance and
treatment efficiency in a treatment of cutting, for example, a blood vessel with a
large diameter, by using heat, can be provided.
Brief Description of Drawings
[0008]
FIG. 1 is a schematic view illustrating a grasping treatment system according to a
first embodiment;
FIG. 2 is a cross-sectional view which schematically illustrates the configuration
of a distal portion of a grasping treatment instrument including a grasping treatment
unit according to the first embodiment, in a state in which a first jaw and a second
jaw are opened;
FIG. 3 is a cross-sectional view which schematically illustrates, in a cross section
perpendicular to the longitudinal axis, the grasping treatment unit according to the
first embodiment, in a state in which the first jaw and second jaw are closed;
FIG. 4 is a perspective view which schematically illustrates the configuration of
a blade and a heating portion of the first jaw according to the first embodiment;
FIG. 5 is a schematic view for explaining a treatment of cutting a blood vessel with
a diameter less than a first longitudinal dimension of a first thermal conduction
portion of the first jaw according to the first embodiment;
FIG. 6 is a schematic view for explaining a treatment of cutting a blood vessel with
a diameter larger than the dimension of a grasping surface in the longitudinal direction
of the first jaw according to the first embodiment;
FIG. 7 is a schematic view illustrating transfer of heat from the heating portion
to the blood vessel in a state in which the grasping surface is in contact with the
blood vessel over the entire length in the longitudinal direction of the first jaw
according to the first embodiment;
FIG. 8 is a schematic view illustrating a variation with time, from the start of heating
of the heating portion, of the temperatures of the first thermal conduction portion
and second thermal conduction portion on the grasping surface in the state of FIG.
7;
FIG. 9 is a schematic view for explaining a treatment of cutting a membranous tissue
by using the grasping treatment unit according to the first embodiment;
FIG. 10 is a schematic view illustrating transfer of heat from the heating portion
to the membranous tissue in a state in which only a distal portion of the grasping
surface is in contact with the membranous tissue, in the first jaw according to the
first embodiment;
FIG. 11 is a schematic view illustrating a variation with time, from the start of
heating of the heating portion, of the temperatures of the first thermal conduction
portion and second thermal conduction portion on the grasping surface in the state
of FIG. 10;
FIG. 12 is a perspective view which schematically illustrates the configuration of
a blade of a first jaw according to a first modification;
FIG. 13 is a perspective view which schematically illustrates the configuration of
a blade of a first jaw according to a second modification;
FIG. 14 is a perspective view which schematically illustrates the configuration of
a blade and a heating portion of a first jaw according to a third modification; and
FIG. 15 is a cross-sectional view which schematically illustrates, in a cross section
perpendicular to the longitudinal axis, a grasping treatment unit according to a fourth
modification, in a state in which the first jaw and second jaw are closed.
Description of Embodiments
(First Embodiment)
[0009] A first embodiment of the present invention will be described with reference to FIG.
1 to FIG. 11.
[0010] FIG. 1 is a view illustrating a grasping treatment system 1. As illustrated in FIG.
1, the grasping treatment system 1 includes a grasping treatment instrument 2. The
grasping treatment instrument 2 has a longitudinal axis C. Here, one side of a direction
parallel to the longitudinal axis C is a distal side (the side of arrow C1 in FIG.
1), and a side opposite to the distal side is a proximal side (the side of arrow C2
in FIG. 1). In this embodiment, the grasping treatment instrument 2 is a thermal treatment
tool which treats a treated target such as a biological tissue by using heat as energy,
and is also a high-frequency treatment instrument which treats a treated target by
using high-frequency electric power (high-frequency current).
[0011] The grasping treatment instrument 2 includes a holding unit (handle unit) 3 which
can be held by a surgeon, and a cylindrical shaft (sheath) 5 which is coupled to the
distal side of the holding unit 3. In this embodiment, the center axis of the shaft
5 is the longitudinal axis C. The holding unit 3 includes a cylindrical case portion
6 which extends along the longitudinal axis C, and a stationary handle 7 which extends
from the cylindrical case portion 6 toward a certain direction crossing the longitudinal
axis C. In this embodiment, the cylindrical case portion 6 is provided coaxial with
the shaft 5, and the shaft 5 is attached to the holding unit 3 by being inserted into
the inside of the cylindrical case portion 6 from the distal side. The stationary
handle 7 is formed integral with the cylindrical case portion 6. In addition, the
holding unit 3 includes a movable handle 8 which is rotatably attached to the cylindrical
case portion 6. By rotating the movable handle 8 relative to the cylindrical case
portion 6, the movable handle 8 performs an opening motion or a closing motion relative
to the stationary handle 7.
[0012] One end of a cable 11 is connected to the holding unit 3 (cylindrical case portion
6). The grasping treatment system 1 includes an energy source unit 10 which is, for
example, an electric power generator. The other end of the cable 11 is connected to
the energy source unit 10. The energy source unit 10 includes an electric power supply,
a converter circuit, and a CPU (Central Processing Unit) or an ASIC (Application Specific
Integrated Circuit). In addition, the energy source unit 10 is electrically connected
to an energy operation input unit 12 such as a footswitch.
[0013] A grasping treatment unit (end effector) 20 is coupled to the distal side of the
shaft 5. The grasping treatment unit 20 includes a first jaw 21 which is a first grasping
portion, and a second jaw 22 which is a second grasping portion. In the grasping treatment
unit 20, a space between the first jaw 21 and second jaw 22 can be opened and closed.
Specifically, the first jaw 21 and second jaw 22 are openable and closable relative
to each other.
[0014] FIG. 2 is a view which schematically illustrates the configuration of a distal portion
of the grasping treatment instrument 2 including the grasping treatment unit 20. FIG.
2 illustrates a state in which the first jaw 21 and second jaw 22 are opened. In addition,
FIG. 3 illustrates, in a cross section perpendicular to the longitudinal axis C, the
first jaw 21 and second jaw 22. In FIG. 3, the first jaw 21 and second jaw 22 are
closed.
[0015] As illustrated in FIG. 2 and FIG. 3, the first jaw 21 has a first jaw axis J1. The
first jaw axis J1 is the center axis of the first jaw 21, and the first jaw (first
grasping portion) 21 extends along the first jaw axis J1 from the proximal portion
toward the distal portion. Here, the direction parallel to the first jaw axis J1 is
the longitudinal direction (first jaw longitudinal direction) of the first jaw 21.
In addition, one side of the longitudinal direction is a distal side (first jaw distal
side) of the first jaw 21, and the side opposite to the distal side (first jaw distal
side) is a proximal side (first jaw proximal side) of the first jaw 21. The distal
side of the first jaw 21 agrees with the side toward the distal portion in the first
jaw 21, and the proximal side of the first jaw 21 agrees with the side toward the
proximal portion in the first jaw 21.
[0016] In addition, the second jaw 22 has a second jaw axis J2. The second jaw axis J2 is
the center axis of the second jaw 22, and the second jaw (second grasping portion)
22 extends along the second jaw axis J2 from the proximal portion toward the distal
portion. Here, the direction parallel to the second jaw axis J2 is the longitudinal
direction (second jaw longitudinal direction) of the second jaw 22. In addition, one
side of the longitudinal direction is a distal side (second jaw distal side) of the
second jaw 22, and the side opposite to the distal side (second jaw distal side) is
a proximal side (second jaw proximal side) of the second jaw 22. The distal side of
the second jaw 22 agrees with the side toward the distal portion in the second jaw
22, and the proximal side of the second jaw 22 agrees with the side toward the proximal
portion in the second jaw 22.
[0017] In the present embodiment, the second jaw 22 is fixed to the shaft 5 in a distal
portion of the shaft 5. The second jaw axis J2 is substantially parallel to the longitudinal
axis C of the shaft 5. The first jaw 21 is attached to the distal portion of the shaft
5 via a fulcrum pin 23. The first jaw 21 is rotatable about the fulcrum pin 23 relative
to the shaft 5. In addition, a rod 25, which has a rod shape, extends within the shaft
5 from the proximal side toward the distal side. The rod 25 is movable along the longitudinal
axis C relative to the shaft 5. A proximal portion of the rod 25 is coupled to the
movable handle 8 in the inside of the cylindrical case portion 6. A distal portion
of the rod 25 is connected to the first jaw 21 via a connection pin 26. By opening
or closing the movable handle 8 relative to the stationary handle 7, the rod 25 moves
along the longitudinal axis C relative to the shaft 5. Thereby, the first jaw 21 rotates
relative to the shaft 5, and the first jaw 21 opens or closes relative to the second
jaw 22. At this time, since the second jaw 22 is fixed to the shaft 5, the second
jaw 22 opens or closes relative to the first jaw 21. Specifically, by the movement
of the rod 25 relative to the shaft 5, the space between the first jaw 21 and second
jaw 22 is opened or closed in the grasping treatment unit 20. Accordingly, the movable
handle 8 functions as an opening-and-closing operations input unit to which an opening
or closing operation for opening or closing the first jaw (first grasping portion)
21 and second jaw (second grasping portion) 22 is input.
[0018] Here, a direction in the first jaw 21 toward the second jaw 22 is a closing direction
(a direction of arrow Y1 in FIG. 2 and FIG. 3) of the first jaw 21, and a direction
in the first jaw 21 away from the second jaw 22 is an opening direction (a direction
of arrow Y2 in FIG. 2 and FIG. 3) of the first jaw 21. The closing direction (first
jaw closing direction) of the first jaw 21 is a certain one direction crossing (perpendicular
to) the first jaw axis J1, and the opening direction (first jaw opening direction)
of the first jaw 21 is the direction opposite to the jaw closing direction. In addition,
a direction in the second jaw 22 toward the first jaw 21 is a closing direction (a
direction of arrow Y3 in FIG. 2 and FIG. 3) of the second jaw 22, and a direction
in the second jaw 22 away from the first jaw 21 is an opening direction (a direction
of arrow Y4 in FIG. 2 and FIG. 3) of the second jaw 22. The closing direction (second
jaw closing direction) of the second jaw 22 is a certain one direction crossing (perpendicular
to) the second jaw axis J2, and the opening direction (second jaw closing direction)
of the second jaw 22 is the direction opposite to the jaw opening direction. In addition,
two directions, which cross (are perpendicular to) the first jaw axis J1 and are perpendicular
to the opening direction and closing directions of the first jaw 21 are width directions
(a direction of arrow W1 and a direction of arrow W2 in FIG. 3). The width directions
(jaw width directions) are directions crossing (perpendicular to) the second jaw axis
J2 and perpendicular to the opening direction and closing directions of the second
jaw 22.
[0019] The second jaw 22 includes a support member (second support member) 31 which is fixed
to the shaft 5, and a receiving member 32 which is fixed to the support member 31.
The support member 31 and receiving member 32 extend along the second jaw axis J2
from the proximal portion to the distal portion of the second jaw 22. A back surface
(second jaw back surface) 27, which is directed in the opening direction (second jaw
opening direction) on the outer surface of the second jaw 22, is formed by the support
member 31. In addition, in the second jaw 22, the receiving member 32 is fixed on
the closing direction side of the support member 31. The receiving member 32 is formed
of an electrically insulating material. Besides, the second jaw 22 includes an electrode
portion (second electrode portion) 36 which is fixed to the receiving member 32. The
electrode portion (electrode member) 36 is formed of an electrically conductive material,
and extends along the second jaw axis J2 from the proximal portion to distal portion
of the second jaw 22.
[0020] In the present embodiment, a counter-surface (second grasping surface) 28, which
is opposed to the first jaw 21 on the outer surface of the second jaw 22, is formed
by the receiving member 32 and electrode portion 36. Specifically, a part of the counter-surface
28 of the second jaw 22 is formed of the electrode portion 36, and another part of
the opposed-surface 28 of the second jaw 22 is formed of the receiving member 32.
The counter-surface (second grasping surface) 28 is a part of the outer surface of
the second jaw 22, and is directed in the closing direction (second jaw closing direction)
of the second jaw 22.
[0021] As illustrated in FIG. 3, a recess portion (groove portion) 35, in which the counter-surface
28 is recessed in the opening direction of the second jaw 22, is formed in the second
jaw 22. The recess portion 35 lies between the electrode portions 36 in the width
direction (jaw width direction) of the second jaw 22. The recess portion 35 extends
along the second jaw axis J2 from the proximal portion to the distal portion of the
second jaw 22. In addition, a middle position M2 in the width direction of the second
jaw 22 is located in the recess portion 35.
[0022] One end of an electric power supply line (second high-frequency electric power supply
line) 37, which is formed of an electric wiring line or the like, is connected to
the electrode portion 36. The electric power supply line 37 extends through the space
between the shaft 5 and rod 25, the inside of the cylindrical case portion 6 and the
inside of the cable 11, and the other end thereof is connected to the energy source
unit 10. The energy source unit 10 can output high-frequency electric power (high-frequency
electric energy), and the high-frequency electric power, which is output from the
energy source unit 10, is supplied to the electrode portion 36 of the second jaw 22
through the electric power supply line 37. By being supplied with the electric power,
the electrode portion 36 functions as one electrode (second electrode) of the high-frequency
electric power. In the meantime, since the receiving member 32 is formed of the electrically
insulating material, the high-frequency electric power is not supplied (transmitted)
to the support member 31 and receiving member 32.
[0023] As illustrated in FIG. 2 and FIG. 3, the first jaw 21 includes a support member (first
support member) 41 which is attached to the shaft 5 and rod 25, and a heat insulation
member 42 which is fixed to the support member 41. The support member 41 and heat
insulation member 42 extend along the first jaw axis J1 from the proximal portion
to the distal portion of the first jaw 21. A back surface (first jaw back surface)
51, which is directed in the opening direction (first jaw opening direction) on the
outer surface of the first jaw 21, is formed by the support member 41. In addition,
in the first jaw 21, the heat insulation member 42 is fixed on the closing direction
side of the support member 41. The heat insulation member 42 is formed of an electrically
insulating material.
[0024] In addition, a blade (treatment portion) 43 is fixed to the closing direction side
(first jaw closing direction side) of the heat insulation member 42. The blade 43
is formed of an electrically conductive material with high heat transferability. The
blade 43 is a heat applying portion which applies heat to a treated target such as
a biological tissue. In the opening direction and closing direction, a cavity 45 is
formed between the heat insulation member 42 and blade 43. The cavity 45 is surrounded
by the heat insulation member 42 and blade 43. In this embodiment, a grasping surface
(first grasping surface) 52 is formed by the blade 43 in a position on the outer surface
of the first jaw 21, which is opposed to the counter-surface (second grasping surface)
28 of the second jaw 22. The grasping surface (first grasping surface) 52 is a part
of the outer surface of the first jaw 21, and is directed in the closing direction
(first jaw closing direction) of the first jaw 21. Accordingly, the blade 43, which
is the heat applying portion, is provided in the grasping surface 52 side part in
the first jaw 21. In addition, a heating portion 40, which produces heat, is disposed
in the cavity 45.
[0025] FIG. 4 is a view illustrating the configuration of the blade 43 and heating portion
40. As illustrated in FIG. 4, one end of an electric power supply line (first high-frequency
electric power supply line) 53, which is formed of an electric wiring line or the
like, is connected to a proximal portion of the blade (treatment portion) 43. The
electric power supply line 53 extends through the space between the shaft 5 and rod
25, the inside of the cylindrical case portion 6 and the inside of the cable 11, and
the other end thereof is connected to the energy source unit 10. High-frequency electric
power (high-frequency electric energy), which is output from the energy source unit
10, is supplied to the blade 43 of the first jaw 21 through the electric power supply
line 53. By being supplied with electric power, the blade 43 functions as an electrode
(first electrode) of high-frequency electric power, which has an electric potential
different from an electric potential of the electrode portion 36. In the meantime,
since the heat insulation member 42 is formed of the electrically insulating material,
the high-frequency electric power is not supplied (transmitted) to the support member
41 and heat insulation member 42.
[0026] As illustrated in FIG. 2 to FIG. 4, the blade 43, which is the heat applying portion,
extends from the proximal portion to distal portion of the first jaw 21. In the blade
43, the grasping surface 52 extends from the proximal portion to distal portion of
the first jaw 21. In addition, the blade 43 is provided with a projection portion
55 in which the grasping surface 52, compared to the other part of the blade 43, projects
toward the second jaw 22 (toward the first jaw closing direction side). In the blade
43, the projection portion 55 extends in such a state as to be continuous from the
proximal portion to distal portion of the first jaw 21. A middle position M1 in the
width direction of the first jaw 21 is located in the projection portion 55. A projection
width dimension B1, which is a dimension of the projection portion 55 in the width
direction of the first jaw 21, is less than a surface width dimension B2 which is
a dimension of the grasping surface 52 (blade 43) in the width direction of the first
jaw 21. For example, the projection width dimension is 1 mm, and the surface width
dimension B2 is 5 mm. In addition, in the projection portion 55, a projection dimension
P1 from a bottom to a projection end thereof is uniform (substantially identical)
from the proximal end to the distal end. The projection dimension P1 of the projection
portion 55 is, for example, 0.4 mm.
[0027] The projection portion 55 can abut on the recess portion 35 of the receiving member
32 in the state in which the first jaw 21 and second jaw 22 are closed. Accordingly,
the recess portion 35 of the receiving member 32 functions as an abutment reception
portion on which the projection portion 55 of the first jaw 21 can abut. By closing
the space between the first jaw 21 and second jaw 22 in the state in which no treated
target lies between the first jaw 21 and second jaw 22, the projection portion 55
abuts on the recess portion (abutment reception portion) 35. In the state in which
the projection portion 55 abuts on the recess portion 35, the blade 43 does not come
in contact with the electrode portion 36 of the second jaw 22, and there is a gap
between the blade 43 and the electrode portion 36. It is thus possible to prevent
a contact between the electrode portion 36 of the second jaw 22 and the blade 43 of
the first jaw 21, which have different electric potentials.
[0028] In addition, one of the width directions of the first jaw 21 is defined as a first
width direction (the direction of arrow W1 in FIG. 3 and FIG. 4), and the direction
opposite to the first width direction is defined as a second width direction (the
direction of arrow W2 in FIG. 3 and FIG. 4). On the grasping surface (first grasping
surface) 52 of the first jaw 21, an inclined surface (first inclined surface) 57A
is continuous with a first width direction side (first jaw width direction side) of
the projection portion 55, and an inclined surface (second inclined surface) 57B is
continuous with a second width direction side (second jaw width direction side) of
the projection portion 55. On the inclined surface (non-contact portion) 57A, the
distance from the counter-surface 28 of the second jaw 22 becomes smaller toward the
second width direction. In addition, on the inclined surface (non-contact portion)
57B, the distance from the opposed-surface 28 of the second jaw 22 becomes smaller
toward the first width direction. Here, when the projection width direction B1 of
the projection portion 55 is 1 mm, each of the dimension of the inclined surface 57A
in the width direction and the dimension of the inclined surface 57B in the width
direction is, for example, 2 mm.
[0029] The heating portion 40 is attached to a setting surface 46 of the blade (heat applying
portion) 43. The setting surface 46 is directed to the opening direction side of the
first jaw 21. Accordingly, the heating portion 40 is located on the opening direction
side (first jaw opening direction side) with respect to the blade 43. The armor of
the heating portion 40 is formed of an electrically insulating material with heat
resistance. Thus, the high-frequency electric power, which is supplied to the blade
43, is not supplied to the heating portion 40. Here, when the heating portion 40 is
provided in one of the two jaws (21, 22), the jaw that is provided with the heating
portion 40 is set as the first jaw (first grasping portion) 21, and the other jaw
that is not provided with the heating portion 40 is set as the second jaw (second
grasping portion) 22. The first jaw 21, which is the heating jaw (heating grasping
portion), is provided with only one heating portion 40, and not provided with a plurality
of heating portions. In the first jaw (heating jaw) 21, the heating portion 40 is
provided over the range from the proximal portion to distal portion in the longitudinal
direction (first jaw longitudinal direction).
[0030] One end of an electric power supply line (first thermal electric power supply line)
58A and one end of an electric power supply line (second thermal electric power supply
line) 58B, which are formed of electric wiring lines or the like, are connected to
the heating portion 40. Each of the electric power supply lines 58A, 58B extends through
the space between the shaft 5 and rod 25, the inside of the cylindrical case portion
6 and the inside of the cable 11, and the other end each thereof is connected to the
energy source unit 10. The energy source unit 10 can output, in addition to the above-described
high-frequency electric power, electric power (thermal electric power) which is supplied
to the heating portion 40. The electric power (electric energy) from the energy source
unit 10 is supplied to the heating portion 40 of the first jaw 21 through the electric
power supply lines 58A, 58B. By the heating portion 40 being supplied with the electric
power, heat occurs by the thermal resistance of a heating wire (not shown) provided
in the heating portion 40. At this time, heat occurs over the entire length of the
heating portion 40 in the longitudinal direction of the first jaw 21. Thus, heat is
produced by the heating portion 40, uniformly over the range from the proximal portion
to distal portion of the first jaw 21.
[0031] In addition, in the blade (treatment portion) 43, the heating portion 40 is attached
to the installing surface 46 over the range from the proximal portion to distal portion
in the longitudinal direction of the first jaw 21. Thus, in the blade 43, the heat
produced by the heating portion 40 is transferred from the opening direction side
(first jaw opening direction side) of the first jaw 21. At this time, in this embodiment,
the heat is transferred (conducted) from the back surface side of the first jaw 21,
equally (uniformly) from the proximal portion to distal portion in the longitudinal
direction of the first jaw 21. Then, the heat, which has been transferred to the blade
43, is transferred (conducted) toward the grasping surface 52 in the blade 43. The
treated target is treated by the heat conducted to the grasping surface (first grasping
surface) 52.
[0032] The blade (treatment portion) 43 includes a first blade forming portion 61, and a
second blade forming portion 62 which is continuous with a distal side of the first
blade forming portion 61. The thermal conductivity of the second blade forming portion
62 is different from the thermal conductivity of the first blade forming portion 61,
and the second blade forming portion 62 is formed of a material having a lower thermal
conductivity than the material of the first blade forming portion 61. For example,
the first blade forming portion 61 is formed of pure copper (thermal conductivity:
about 400 W/m · K), and the second blade forming portion 62 is formed of a stainless
alloy (thermal conductivity: about 20 W/m · K) which has a lower thermal conductivity
than a copper alloy. Besides, for example, the first blade forming portion 61 may
be formed of any one of a copper alloy, pure aluminum, and an aluminum alloy, and
the second blade forming portion 62 may be formed of a heat resistant plastic or ceramic
having resistance to temperatures of, e.g. about 350°C. Thus, the first blade forming
portion 61 is formed of a material which is any one of pure copper, a copper alloy,
pure aluminum, and an aluminum alloy, and the second blade forming portion 62 is formed
of a material having a lower thermal conductivity than the material of the first blade
forming portion 61.
[0033] The first blade forming portion 61 includes a first thermal conduction portion 63
which forms a part of the projection portion 55, and the second blade forming portion
62 includes a second thermal conduction portion 65 which forms another part of the
projection portion 55, which is different from the part formed by the first thermal
conduction portion 63. The projection portion 55 is formed of the first thermal conduction
portion 63 and second thermal conduction portion 65. Since the first thermal conduction
portion 63 is a part of the first blade forming portion 61 and the second thermal
conduction portion 65 is a part of the second blade forming portion 62, the thermal
conductivity of the second thermal conduction portion 65 is lower than that of the
first thermal conduction portion 63. In this embodiment, the first thermal conduction
portion 63 extends from the proximal end toward the distal portion side of the projection
portion 55, and the second thermal conduction portion 65 extends from the distal end
toward the proximal portion side of the projection portion 55.
[0034] In the projection portion 55, the second thermal conduction portion 65 is continuous
with the distal portion side (jaw distal side) of the first thermal conduction portion
63. Specifically, the first thermal conduction portion 63 and the second thermal conduction
portion are continuous in the longitudinal direction of the first jaw 21. Accordingly,
heat can be directly conducted between the first thermal conduction portion 63 and
the second thermal conduction portion 65. The first thermal conduction portion 63
(first blade forming portion 61) has a first longitudinal dimension L1 in the longitudinal
direction of the first jaw 21, and the second thermal conduction portion 65 (second
blade forming portion 62) has a second longitudinal dimension L2 in the longitudinal
direction of the first jaw 21. The second longitudinal dimension L2 is less than the
first longitudinal dimension L1. For example, the first longitudinal dimension L1
is about 14 mm to 16 mm, whereas the second longitudinal dimension L2 is about 2 mm.
Accordingly, in the projection portion 55, only the distal portion becomes the second
thermal conduction portion 65, the most part excluding the distal portion becomes
the first thermal conduction portion 63.
[0035] In addition, the first blade forming portion 61 includes a first base portion 66,
and the second blade forming portion 62 includes a second base portion 67. Since the
first base portion 66 is a part of the first blade forming portion 61, the first base
portion 66 is formed of the same material as the first thermal conduction portion
63, and has the same thermal conductivity as the first thermal conduction portion
63. The first thermal conduction portion 63 projects from the first base portion 66
toward the second jaw 22 (the closing direction side of the first jaw 21). In addition,
since the second base portion 67 is a part of the second blade forming portion 62,
the second base portion 67 is formed of the same material as the second thermal conduction
portion 65, and has the same thermal conductivity as the second thermal conduction
portion 65. The second thermal conduction portion 65 projects from the second base
portion 67 toward the second jaw 22 (the closing direction side of the first jaw 21).
Furthermore, the second base portion 67 is continuous with the distal portion side
of the first base portion 66. Thus, heat can be directly conducted between the first
base portion 66 and the second base portion 67
[0036] Next, the functions and advantageous effects of the grasping treatment unit 20, grasping
treatment instrument 2 and grasping treatment system 1 of the present embodiment will
be described. When a treated target, such as a biological tissue, is to be treated
by using the grasping treatment system 1, the grasping treatment unit 20 (first jaw
21 and second jaw 22) is inserted into the body, and the treated target is disposed
between the first jaw 21 and second jaw 22. In addition, the movable handle 8 is closed
relative to the stationary handle 7, and a closing operation of the grasping treatment
unit 20 is input. Thereby, the space between the first jaw 21 and second jaw 22 is
closed, and the treated target is grasped between the first jaw 21 and second jaw
22. In the state in which the treated target is grasped, an energy operation is input
by the energy operation input unit 16. Thereby, from the energy source unit 10, electric
power (thermal electric power) is output, and high-frequency electric power is output.
[0037] Then, by the electric power being supplied to the heating portion 40 from the energy
source unit 10, heat is produced by the heating portion 40, and the produced heat
is transferred to the grasping surface (first grasping surface) 52 which is formed
on the blade 43 of the first jaw 21. Thereby, the treated target, which is in contact
with the grasping surface 52, is cauterized, and the treated target is cut and opened.
Here, by decreasing the calorific value of the heating portion 40 and lowering the
temperature of the grasping surface 52, the treated target is coagulated. The calorific
value of the heating portion 40 can be adjusted by adjusting the electric power (the
electric power that is output from the energy source unit 10) that is supplied to
the heating portion 40. When the treated target is cut and opened (abscissed), the
temperature of the grasping surface 52 is about 250°C to 300°C. When the treated target
is coagulated, the temperature of the grasping surface 52 becomes about 200°C.
[0038] In addition, by the high-frequency electric power being supplied from the energy
source unit 10 to the electrode portion 36 of the second jaw 22 and the blade 43 of
the first jaw 21, the electrode portion 36 and blade 43 function as electrodes having
mutually different electric potentials. Thereby, a high-frequency current flows between
the electrode portion 36 and blade 43 through the treated target grasped between the
first jaw 21 and second jaw 22. By the high-frequency current, the treated target
is denatured and the coagulation is promoted.
[0039] FIG. 5 is a view illustrating a treatment of cutting (cutting and opening) a blood
vessel V1 with a diameter (thickness dimension) less than the first longitudinal dimension
L1 of the first thermal conduction portion 63 in the longitudinal direction of the
first jaw 21. As illustrated in FIG. 5, when the blood vessel V1 with the diameter
less than the first longitudinal dimension L1 is cut, the blood vessel V1 is abscissed
in the state in which the entire dimension (entire width) of the blood vessel V1 in
the diametrical direction (thickness direction) is put in contact with the first blade
forming portion 61 on the grasping surface 52. At this time, the second blade forming
portion 62 on the grasping surface 52 is not put in contact with the blood vessel
V1. Specifically, the blood vessel V1 is grasped by those parts of the first jaw 21
and second jaw 22, which are as possible as the proximal side. A pressure acting from
the first jaw 21 is high in that part of the blood vessel V1, which is put in contact
with the projection portion 55 (first thermal conduction portion 63). Thus, the blood
vessel V1 is cut by the heat from the first thermal conduction portion 63 and by the
pressure from the first jaw 21, and a cut part 71 is formed in that part of the blood
vessel V1, which is in contact with the first thermal conduction portion 63.
[0040] On the other hand, on both sides of the first thermal conduction portion 63 in the
width direction of the first jaw 21, the blood vessel V1 does not receive the pressure
by the first thermal conduction portion 63 (projection portion 55). In addition, on
both sides of the first thermal conduction portion 63 in the width direction of the
first jaw 21, the pressure acting on the blood vessel V1 from the first jaw 21 is
less than the pressure by the first thermal conduction portion 63 (projection portion
55). Thus, those parts of the blood vessel V1, which are in contact with the grasping
surface 52 on both sides of the first thermal conduction portion 63 in the width direction,
are not cut by the heat and pressure, but is coagulated. Thus, seal parts (seal margins)
72A and 72B are formed on both sides of the cut part 71 in the width direction of
the first jaw 21 (the extension direction of the blood vessel V1). For example, when
the projection width dimension B1 of the projection portion 55 is 1 mm and the surface
width dimension of the grasping surface 52 is 5 mm, the seal part (72A or 72B) of
about 2 mm is formed on each of both sides of the cut part 71 in the width direction
of the first jaw 21 (the extension direction of the blood vessel V1). An end portion
of each seal part 72A, 72B is formed by the abscission part 71, and, in the treatment
of cutting the blood vessel V1, cutting and opening (cutting) is performed after the
seal part 72A, 72B is coagulated. Specifically, the end portion of the seal part 72A,
72B is coagulated at the same time as cutting of the blood vessel V1 or earlier than
the cutting. Thus, the outflow of blood from the blood vessel V1 is prevented in the
treatment using the grasping treatment instrument 2. Thereby, in the treatment of
cutting the blood vessel V1, the treatment performance and treatment efficiency can
be secured.
[0041] FIG. 6 is a view illustrating a treatment of cutting (cutting and opening) a blood
vessel V2 with a diameter (thickness dimension) larger than the dimension (entire
length) of the grasping surface 52 in the longitudinal direction of the first jaw
21. As illustrated in FIG. 6, when the blood vessel V2 with a diameter larger than
the entire length of the grasping surface 52 in the longitudinal direction is cut,
first cutting is performed in the state in which the grasping surface 52 over the
entire length in the longitudinal direction is put in contact with the blood vessel
V2. In the first cutting, the blood vessel V2, not in the entire dimension (entire
width) but only in a part thereof in the diametric direction (thickness direction),
comes in contact with the grasping surface 52, and that part of the blood vessel V2,
which is not in contact with the grasping surface, remains uncut. Thus, after the
first abscission, an uncut part (to-be-cut part) 76, together with the cut part 75,
is formed.
[0042] FIG. 7 is a view illustrating transfer of heat from the heating portion 40 to the
blood vessel V2 in a state in which the grasping surface 52 over the entire length
in the longitudinal direction is in contact with the blood vessel (treated target)
V2. In addition, FIG. 8 illustrates a variation with time, from the start of heating
of the heating portion 40, of the temperatures of the first thermal conduction portion
63 and second thermal conduction portion 65 on the grasping surface 52 in the state
of FIG. 7. In FIG. 8, the ordinate indicates temperature, and the abscissa indicates
time. As described above, in the blade (treatment portion) 43, the heat produced by
the heating portion 40 is transferred from the opening direction side of the first
jaw 21, uniformly from the proximal portion to the distal portion. In addition, in
the blade 43, the heat is conducted toward the grasping surface 52. Here, the thermal
conductivity of the second thermal conduction portion 65 (second blade forming portion
62) is lower than that of the first thermal conduction portion 63 (first blade forming
portion 63).
[0043] Because of the above-described configuration, as illustrated in FIG. 8, in the first
thermal conduction portion 63 which forms the most part of the projection portion
55 excluding the distal portion, the temperature of the grasping surface 52 rises
to 250°C to 300°C at which the treated target can be cut and opened, instantaneously
(e.g. about 5 seconds) from a heating start time t0 of the heating portion 40. Accordingly,
in the first cutting, the blood vessel V2 is cut by the heat from the first thermal
conduction portion 63 and the pressure from the first jaw 21, and the cut part 75
is formed in that part of the blood vessel V2, which is in contact with the first
thermal conduction portion 63. At this time, like the case of abscissing the blood
vessel V1 with the diameter which is not large, seal parts (seal margins) 77A and
77B are formed on both sides of the cut part 75 in the width direction of the first
jaw 21 (the extension direction of the blood vessel V2).
[0044] On the other hand, the thermal conductivity of the second thermal conduction portion
65, which forms the distal portion of the projection portion 55, is lower than the
thermal conductivity of the first thermal conduction portion 63. Thus, even after
the passage of a certain length of time from the heating start time t0 of the heating
portion 40, the temperature of the grasping surface 52 does not rise to 250°C to 300°C
at which the treated target can be cut and opened, and the temperature of the grasping
surface 52 is about 200°C. Accordingly, in the first cutting, that part of the the
blood vessel V2, which is in contact with the second thermal conduction portion 65,
is coagulated, and a seal part (seal margin) 78 is formed in that part of the blood
vessel V2, which was coagulated by the second thermal conduction portion 65. For example,
when the second longitudinal dimension L2 of the second thermal conduction portion
65 in the longitudinal direction is 2 mm, the seal part 78 of about 2 mm is formed.
[0045] Specifically, in the present embodiment, as illustrated in FIG. 7, in the state in
which the grasping surface 52 over the entire length in the longitudinal direction
is put in contact with the blood vessel V2, the calorific value per unit area of the
heat, which is transferred from the second thermal conduction portion 65 to the blood
vessel V2, is smaller than the calorific value per unit area of the heat, which is
transferred from the first thermal conduction portion 63 to the blood vessel V2. Thus,
in the blood vessel V2, the cut part 75 is formed in that part of the blood vessel
V2, which is in contact with the first thermal conduction portion 63, and the seal
part 78 is formed in that part of the blood vessel V2, which is in contact with the
second thermal conduction portion 65.
[0046] By the first abscission being performed as described above, the seal part 78 is formed
between the cut part 75 and uncut part 76 after the first cutting. Thereby, in the
treatment of cutting the thick blood vessel V2, at the same time as performing the
first cutting of the blood vessel V2, coagulation is performed between the cut part
75 in the first cutting and the uncut part 76. After the first abscission is carried
out, the first jaw 21 and second jaw 22 are moved, and the uncut part 76 including
the seal part 78 is put in contact with the first thermal conduction portion 63 of
the projection portion 55. Then, in the state in which the uncut part 76 is put in
contact with the grasping surface 52 by the first thermal conduction portion 63, second
cutting is performed. Thereby, the uncut part 76 in the first cutting is cut, and
a cut part 81 is formed. The cut part 81 is formed in the state in which the cut part
81 is continuous with the cut part 75 in the first cutting. At this time, like the
first abscission, seal parts (seal margins) 82A and 82B are formed on both sides of
the cut part 81 in the width direction of the first jaw 21 (the extension direction
of the blood vessel V2).
[0047] As described above, in the present embodiment, even when the blood vessel V2 with
the large diameter (the uncut part 76 will occur if only the first cutting is performed)
is to be cut, the seal part (seal margin) 78 is formed between the cut part 75 and
uncut part 76 of the blood vessel V2 after the first cutting. By the formation of
the seal part 78, coagulation between the cut part 75 and uncut part 76 in the first
cutting can be effectively performed. Thereby, in the treatment of cutting the large-diameter
(thick) blood vessel V2, the outflow of blood is prevented, and the treatment performance
and treatment efficiency can be secured.
[0048] Moreover, in this embodiment, simply by varying the thermal conductivity between
the distal portion (second thermal conduction portion 65) and the portion (first thermal
conduction portion 63) other than the distal portion in the projection portion 55,
that part of the blood vessel V2, which is in contact with the first thermal conduction
portion 63, is cut, and that part of the blood vessel V2, which is in contact with
the second thermal conduction portion 65, is coagulated. For example, by lowering
the calorific value of heat from the heating portion (40) only in the distal portion
in the first jaw (22), the temperature of only the distal portion in the projection
portion 55 can be lowered. However, in this case, the configuration of the wiring,
etc. between the heating portion (40) and the energy source unit (10) becomes complex,
and the control of the output state of electric power from the energy source unit
(10) also becomes complex. Specifically, in the present embodiment, by the simple
configuration and the simple output control of electric power, it is realized that
the calorific value of heat, which is transferred to the blood vessel (treated target)
V2, can be decreased only in the distal portion (second thermal conduction portion
65) of the projection portion 55 of the first jaw 21.
[0049] FIG. 9 is a view illustrating a treatment of cutting (cutting and opening) a membranous
tissue M. As illustrated in FIG. 9, when the membranous tissue M is cut, cutting is
performed in the state in which only the distal portion of the grasping surface 52
is put in contact with the membranous tissue M. Accordingly, in the projection portion
55, only the second thermal conduction portion 65, which is located in the distal
portion, is put in contact with the membranous tissue M, and the first thermal conduction
portion 63 is not put in contact with the membranous tissue M.
[0050] FIG. 10 is a view illustrating movement of heat from the heating portion 40 to the
membranous tissue M in a state in which only the distal portion of the grasping surface
52 is in contact with the membranous tissue (treatment target) M. In addition, FIG.
11 illustrates a variation with time, from the start of heating of the heating portion
40, of the temperatures of the first thermal conduction portion 63 and second thermal
conduction portion 65 on the grasping surface 52 in the state of FIG. 10. In FIG.
11, the ordinate indicates temperature, and the abscissa indicates time. As illustrated
in FIG. 11, even when only the distal portion of the projection portion 55 is in contact
with the membranous tissue M, the temperature of the grasping surface 52 rises to
250°C to 300°C at which the treated target can be cut and opened, instantaneously
from the heating start time t0 of the heating portion 40, in the first thermal conductivity
portion 63 which forms the most part of the projection portion 55 excluding the distal
portion. However, in the treatment of abscissing the membranous tissue M, the first
thermal conduction portion 63 is not put in contact with the membranous tissue M.
Thus, the membranous tissue M is not cut by the first thermal conductivity portion
63.
[0051] Additionally, heat can be directly conducted between the first thermal conductivity
portion 63 and second thermal conductivity portion 65. Accordingly, as illustrated
in FIG. 10, by the first thermal conductivity portion 63 not being put in contact
with the membranous tissue M, no heat is conducted to the membranous tissue M from
the first thermal conductivity portion 63. The heat, which is transferred to the first
thermal conduction portion 63 from the opening direction side of the first jaw 21,
is conducted to the second thermal conductivity portion 65. Specifically, in the state
in which only the second thermal conductivity portion 65 is in contact with the membranous
tissue M, heat is transferred to the second thermal conduction portion 65 from the
opening direction side of the first jaw 21, and heat is conducted to the second thermal
conduction portion 65 through the first thermal conduction portion 63. Thus, also
in the second thermal conduction portion 65 with the low thermal conductivity, the
temperature of the grasping surface 52 rises to 250°C to 300°C at which the treated
target can be cut and opened, if a certain length of time has passed since the heating
start time t0 of the heating portion 40.
[0052] Accordingly, by the heat occurring in the heating portion 40 in the state in which
only the second thermal conduction portion 65 is in contact with the membranous tissue
M, the membranous tissue M is cut by the heat from the second thermal conduction portion
65 and the pressure from the first jaw 21, and a cut part 85 is formed in that part
of the membranous tissue M, which is in contact with the second thermal conduction
portion 65. At this time, like the cutting of the blood vessel (V1, V2), seal parts
(seal margins) 87A and 87B are formed by the grasping surface 52 on both sides of
the cut part 85 in the width direction of the first jaw 21 (the direction perpendicular
to the direction of cutting).
[0053] As described above, in the present embodiment, even when abscission is performed
in the state in which only the distal portion (second thermal conduction portion 65)
of the grasping surface 52 is put in contact with the treated target (membranous tissue
M), the treated target can properly be cut by the heat. Specifically, in the treatment
of cutting the treated target with which only the distal portion of the grasping surface
52 is put in contact, the treatment efficiency and treatment performance can be secured.
[0054] Moreover, in this embodiment, blood vessels (V1, V2) of various diameters can properly
be cut by the single grasping treatment instrument 2, and the treatment of cutting
the treated target can properly be performed by putting only the distal portion of
the grasping surface 52 in contact with the treated target. Specifically, by the single
grasping treatment instrument 2, various kinds of cutting treatments (cutting and
opening treatments) can properly be performed.
(Modifications)
[0055] In the first embodiment, in the blade (treatment portion) 43 including the projection
portion 55, the second blade forming portion 62 with a low thermal conductivity is
formed in the entirety of the distal portion. However, the restriction to this is
unnecessary. For example, as illustrated in FIG. 12 as a first modification, in the
blade 43, a first blade forming portion 61 with a high thermal conductivity may be
formed in the most part of the blade excluding the distal portion of the projection
portion 55, and a second blade forming portion 62 with a low thermal conductivity
may be formed in only the distal portion of the projection portion 55. In the present
modification, a base portion 68 extends from the proximal end to distal end of the
blade 43 that is the heat applying portion. Since the base portion 68 is a part of
the first blade forming portion 61, the base portion 68 is formed of the same material
as the first thermal conduction portion 63, and has the same thermal conductivity
as the first thermal conduction portion 63. In addition, the projection portion 55,
which is formed of the first thermal conduction portion 63 and second thermal conduction
portion 65, projects from the base portion 68 toward the second jaw 22 (the closing
direction side of the first jaw 21). Accordingly, in the present modification, the
thermal conductivity is also high in that part of the distal portion of the blade
43, which excludes the projection portion 55. In addition, the entirety of the second
blade forming portion 62 becomes the second thermal conduction portion 65.
[0056] In the present modification, like the first embodiment, the first thermal conduction
portion 63, which is formed of the first blade forming portion 61, is provided in
the projection portion 55, and the second thermal conduction portion 65, which is
formed of the second blade forming portion 62, is continuous with the distal portion
side of the first thermal conduction portion 63 in the projection portion 55. Accordingly,
in the projection portion 55, the second thermal conduction portion 65, which has
a lower thermal conductivity than the first thermal conduction portion 63, is continuous
with the distal portion side (distal side) of the first thermal conduction portion
63. In addition, in the projection portion 55, only the distal portion is formed of
the second thermal conduction portion 65, and the portion other than the distal portion
is formed of the first thermal conduction portion 63. Therefore, in the present modification,
like the first embodiment, various cutting treatments can properly be performed.
[0057] Additionally, as illustrated in FIG. 13 as a second modification, that part of the
blade 43, which excludes the projection portion 55, may be a third blade forming portion
69 with a thermal conductivity which is different from the thermal conductivities
of the first blade forming portion 61 and second blade forming portion 62. Thus, the
first blade forming portion 61, second blade forming portion 62 and third blade forming
portion 69 have different thermal conductivities relative to one another. In addition,
it is preferable that the third blade forming portion 69, first blade forming portion
61 and second blade forming portion 62 have, in the named order, successively decreasing
thermal conductivities. In the present modification, the first blade forming portion
61 and second blade forming portion 62 are provided only in the projection portion
55, and that part of the blade 43, which excludes the projection portion 55, is formed
of the third blade forming portion 69. Thus, the first thermal conduction portion
63 and second thermal conduction portion 65 project from the third blade forming portion
69, which is the base portion, toward the second jaw 22 (the closing direction side
of the first jaw 21). Accordingly, the entirety of the first blade forming portion
61 becomes the first thermal conduction portion 63, and the entirety of the second
blade forming portion 62 becomes the second thermal conduction portion 65.
[0058] However, in this modification, like the first embodiment, the first thermal conduction
portion 63, which is formed of the first blade forming portion 61, is provided in
the projection portion 55, and the second thermal conduction portion 65, which is
formed of the second blade forming portion 62, is continuous with the distal portion
side of the first thermal conduction portion 63 in the projection portion 55. Accordingly,
in the projection portion 55, the second thermal conduction portion 65, which has
a lower thermal conductivity than the first thermal conduction portion 63, is continuous
with the distal portion side (distal side) of the first thermal conduction portion
63. In addition, in the projection portion 55, only the distal portion is formed of
the second thermal conduction portion 65, and the portion other than the distal portion
is formed of the first thermal conduction portion 63. Therefore, in the present modification,
like the first embodiment, various cutting treatments can properly be performed.
[0059] Additionally, in the blade 43 of the first embodiment, the heat is transferred from
the back surface side of the first jaw 21, equally (uniformly) from the proximal portion
to distal portion in the longitudinal direction of the first jaw 21. However, the
restriction to this is unnecessary. For example, as illustrated in FIG. 14 as a third
modification, the heating portion 40 may be put in contact with only the first blade
forming portion 61 with the high thermal conductivity, and the heating portion 40
may not be put in contact with the second blade forming portion 62 with the low thermal
conductivity. In the present modification, in the blade 43, the heat is transferred
to the first blade forming portion 61 from the opening direction side of the first
jaw 21. At this time, the heat is transferred from the back surface side of the first
jaw 21, equally (uniformly) from the distal portion to proximal portion of the first
blade forming portion 61. In addition, the heat is conducted to the second blade forming
portion 62 through the first blade forming portion 61.
[0060] In the meantime, a configuration, in which heat is transferred to only the second
blade forming portion 62 with the low thermal conductivity from the back surface side
of the first jaw 21 and no heat is transferred to the first blade forming portion
61 with the high thermal conductivity from the back surface side of the first jaw
21, is applied to none of the modifications. Specifically, a configuration, in which
heat is transferred to only the second blade forming portion 62 from the opening direction
side of the first jaw 21 and the heat is transferred to the first blade forming portion
61 through the the second blade forming portion 62, is applied to none of the modifications.
[0061] Additionally, in the projection portion 55 of the blade 43, the second thermal conduction
portion (65) with the low thermal conductivity may be provided in only the proximal
portion. In this case, too, in the projection portion 55, the first thermal conduction
portion (63) and second thermal conduction portion (65), which have mutually different
thermal conductivities, are continuous in the longitudinal direction of the first
jaw 21, and heat can be directly conducted between the first thermal conduction portion
(63) and second thermal conduction portion (65).
[0062] Additionally, as illustrated in FIG. 15 as a fourth modification, the first jaw (first
grasping portion) 21, which is provided with the heating portion 40, may be fixed
to the shaft 5. In this modification, the second jaw 22, which is not provided with
the heating portion 40, is rotatably attached to the shaft 5. As illustrated in FIG.
15, in the present modification, like the first embodiment, the second jaw 22 is formed
of the support member 31, receiving member 32 and electrode portion 36. In addition,
the counter-surface (second grasping surface) 28, which is opposed to the first jaw
21, is formed by the receiving member 32 and electrode portion 36.
[0063] Additionally, like the first embodiment, the first jaw 21 is formed of the support
member 41, heat insulation member 42, blade 43 and heating portion 40. In addition,
the grasping surface (first grasping surface) 52, which is opposed to the second jaw
22, is formed by the blade 43. In this modification, too, only one heating portion
40 is provided on the first jaw (heating jaw) 21. In addition, the blade 43 is provided
with the projection portion 55, and the projection portion 55 includes the first thermal
conduction portion 63, and the second thermal conduction portion 65 which has a lower
thermal conductivity than the first thermal conduction portion 63. Besides, in the
projection portion 55, the first thermal conduction portion 63 is continuous with
the second thermal conduction portion 65 in the longitudinal direction of the first
jaw 21, and heat can be directly conducted between the first thermal conduction portion
63 and the second thermal conduction portion 65.
[0064] Additionally, in a certain modification, both the first jaw 21 and the second jaw
22 serve as heating jaws (heating grasping portions) which are provided with heating
portions (40). In this case, each heating jaw (21, 22) is provided with only one heating
portion (40). In addition, each heating jaw (each of the first jaw 21 and second jaw
22) is provided with a heat applying portion (blade 43). Like the first jaw 21 of
the above-described embodiment, etc., the heat applying portion (blade 43) is provided
with a projection portion (55). Each projection portion (55) includes a first thermal
conduction portion (63), and a second thermal conduction portion (65) having a lower
thermal conductivity than the first thermal conduction portion (63). In addition,
in each projection portion (55), the first thermal conduction portion (63) is continuous
with the second thermal conduction portion (65) in the longitudinal direction of the
heating jaw, and heat can be directly conducted between the first thermal conduction
portion (63) and second thermal conduction portion (65).
[0065] Additionally, in the above-described embodiment, etc., one (e.g. second jaw 22) of
the two jaws (21, 22) is fixed to the shaft 5, and the other (e.g. first jaw 21) of
the two jaws (21, 22) is rotatable relative to the shaft 5. However, the restriction
to this is unnecessary. In a certain modification, both the first jaw 21 and the second
jaw 22 may be rotatably attached to the shaft 5. In this case, by moving the rod 25
along the longitudinal axis C, both the first jaw 21 and the second jaw 22 rotate
relative to the shaft 5. Thereby, in the grasping treatment unit 20, a space between
the first jaw 21 and second jaw 22 is opened or closed.
[0066] Additionally, in the above-described embodiment, high-frequency electric power is
output from the energy source unit 10. However, the restriction to this is unnecessary.
Specifically, the first jaw 21 and second jaw 22 do not need to be supplied with high-frequency
electric power. Accordingly, it should suffice if at least the heating portion 40
is provided on the first jaw 21 that is one of the two jaws (21, 22), and the energy
source unit 10 outputs electric power which is supplied to the heating portion 40.
[0067] In the above-described embodiment, etc. (including the modifications), in the grasping
treatment unit (20), the space between the first jaw (21) and second jaw (22) can
be opened or closed, and the first jaw (21) is provided with the heat applying portion
(43). The heat applying portion (43) is provided with the grasping surface (52) that
is the outer surface opposed to the second jaw (22), and heat is conducted in the
heat applying portion (43) toward the grasping surface (52). The projection portion
(55) is continuously provided in the heat applying portion (43) from the distal portion
to the proximal portion, and, in the projection portion (55), the grasping surface
(52), compared to the other part of the heat applying portion (43), projects toward
the second jaw (22). The projection portion (55) includes the first thermal conduction
portion (63), and the second thermal conduction portion (65) with a thermal conductivity
which is different from the thermal conductivity of the first thermal conduction portion
(63). The second thermal conduction portion (65) is continuous with the first thermal
conduction portion (63) in the longitudinal direction of the first jaw (21), and heat
can be directly conducted between the first thermal conduction portion (63) and second
thermal conduction portion (65).
[0068] Although the embodiments, etc. of the present invention have been described above,
the present invention is not limited to the above-described embodiments, etc., and,
needless to say, various modifications can be made without departing from the spirit
of the invention.
1. A grasping treatment unit comprising:
a first jaw extending from a proximal portion toward a distal portion thereof;
a second jaw extending from a proximal portion toward a distal portion thereof, and
being openable and closable relative to the first jaw;
a heat applying portion including, on an outer surface of the first jaw, a grasping
surface opposed to the second jaw, the heat applying portion being provided in a grasping-surface-side
part in the first jaw;
a projection portion provided in the heat applying portion in a state in which the
projection portion is continuous from the proximal portion to the distal portion of
the first jaw, the projection portion being configured such that the grasping surface,
compared to the other part of the heat applying portion, projects toward the second
jaw;
a first thermal conduction portion provided in the projection portion; and
a second thermal conduction portion being continuous with a distal portion side of
the first thermal conduction portion in the projection portion, and configured such
that heat is directly conductible between the second thermal conduction portion and
the first thermal conduction portion, the second thermal conduction portion having
a thermal conductivity which is different from a thermal conductivity of the first
thermal conduction portion.
2. The grasping treatment unit of Claim 1, wherein the thermal conductivity of the second
thermal conduction portion is lower than the thermal conductivity of the first thermal
conduction portion.
3. The grasping treatment unit of Claim 2, wherein the first thermal conduction portion
is formed of a material which is any one of pure copper, a copper alloy, pure aluminum,
and an aluminum alloy, and
the second thermal conduction portion is formed of a stainless alloy, the thermal
conductivity of which is lower than the thermal conductivity of the material of which
the first thermal conduction portion is formed.
4. The grasping treatment unit of Claim 1, wherein the heat applying portion includes
a first base portion which is formed of the same material as the first thermal conduction
portion, and a second base portion which is continuous with a distal portion side
of the first base portion and which is formed of the same material as the second thermal
conduction portion,
the first thermal conduction portion projects from the first base portion toward the
second jaw, and
the second thermal conduction portion projects from the second base portion toward
the second jaw.
5. The grasping treatment unit of Claim 1, wherein the heat applying portion includes
a base portion which is formed of the same material as the first thermal conduction
portion, and
the first thermal conduction portion and the second thermal conduction portion project
from the base portion toward the second jaw.
6. The grasping treatment unit of Claim 1, wherein the heat applying portion includes
a base portion having a thermal conductivity which is different from the thermal conductivities
of the first thermal conduction portion and the second thermal conduction portion,
and
the first thermal conduction portion and the second thermal conduction portion project
from the base portion toward the second jaw.
7. The grasping treatment unit of Claim 1, wherein the first jaw includes a heating portion
configured to produce heat which is transferred to the heat applying portion from
an opening direction side of the first jaw.
8. The grasping treatment unit of Claim 1, wherein when a direction, which is perpendicular
to a longitudinal direction of the first jaw and is perpendicular to an opening direction
and a closing direction of the first jaw, is defined as a width direction, a projection
width dimension of the projection portion in the width direction is less than a surface
width dimension of the grasping surface in the width direction.
9. The grasping treatment unit of Claim 1, wherein a projection dimension of the projection
portion from a bottom to a projection end thereof is uniform from a proximal end to
a distal end thereof.
10. The grasping treatment unit of Claim 1, wherein the heat applying portion is formed
of an electrically conductive material, and functions as an electrode by high-frequency
electric power being transmitted to the heat applying portion, and
the second jaw includes a counter-surface which is, on an outer surface of the second
jaw, opposed to the grasping surface, and an electrode portion which forms a part
of the counter-surface, which is formed of an electrically conductive material and
which functions as an electrode with an electric potential different from an electric
potential of the heat applying portion by high-frequency electric power being transmitted
to the electrode portion.
11. The grasping treatment unit of Claim 10, wherein the counter-surface of the second
jaw includes an abutment reception portion which is formed of an electrically insulating
material, and on which the projection portion is able to abut in a state in which
a space between the first jaw and the second jaw is closed, and
the electrode portion of the second jaw has a gap from the heat applying the portion
in a state in which the projection portion abuts on the abutment reception portion.
12. A grasping treatment instrument comprising:
the grasping treatment unit of Claim 1;
a holding unit which is provided on a proximal side with respect to the grasping treatment
unit, and which is capable of being held; and
an opening-and-closing operations input unit which is provided in the holding unit,
and to which an opening or closing operation of opening or closing a space between
the first jaw and the second jaw of the grasping treatment unit is input.
13. A grasping treatment system comprising:
the grasping treatment unit of Claim 1;
a heating portion provided in the first jaw and configured to produce heat which is
transferred to the grasping surface from an opening direction side of the first jaw;
and
an energy source unit configured to cause the heating portion to produce the heat,
by outputting electric power which is supplied to the heating portion.